A 27-year-old woman presents with a red rash over her cheeks, and pain and swelling in both knees as well as several small joints in her hands. She notes that the rash is worse with sun exposure. Medical evaluation reveals oral ulceration, positive ANA, and 3+ proteinuria. Which of the following is the most likely mechanism for the renal damage in this condition?
High-Yield Explanation
Renal disease is usually secondary to deposition of circulating immune complex. Although most patients with SLE have such deposits, only half have clinical nephritis as defined by proteinuria. Renal biopsy can provide both prognostic and therapeutic information.